Treating Homosexuality: A Therapist's View

"Treatment aims essentially at 'growing out' of homosexuality," says Dr. Awsam Hanna.

IOL: What are the main reasons that lead to same-sex tendencies?

Hanna: Many factors are responsible together. The most important is the failure of bonding between the child with the same sex parent (the relation between the son and his father, and the daughter with her mother.) Other genetic, upbringing, social and cultural issues play roles. For each individual those factors interact together in a unique way and result in his/her attraction to the same sex.

IOL: A question that might come up on many people’s minds is how does it start with homosexuals? How does one feel that he or she has this tendency, and how do they decide to eventually seek treatment?

Hanna: Since early childhood, the child who will be attracted to the same sex is different than the members of his or her gender. By the age of 12-15, the adolescent starts to feel different, with some romantic and/or sexual attractions to the same sex. Usually, there is history of sexual play with the same sex. At this age, the sexual play becomes more serious.

By the age of 16-17, the adolescent starts to realize that he or she is totally attracted to the same sex. Most of the times, he or she keeps this secret to him or herself and tries to stop or change, but very few of them seek treatment.

Usually, the treatment is not successful or they are not persistent in treatment and they either feel frustrated and depressed or seek to reconcile with the fact that they are "gay." Many continue to be depressed even after reconciling with their sexual orientation.

Some adolescents may go through a period of confusion about their sexual orientation around the age of 14-15, and then by the age of 17-18 become attracted to the opposite sex and forget about it altogether.

Others may keep a dormant attraction to the same sex or remember the pleasure of same-sex sexual play and may practice it from time to time as a form of a "secret life" even after they have gotten married and live a heterosexual lifestyle.

IOL: How does treatment work? Is it the same in all cases, or does it differ from one case to another?

Hanna: Treatment aims essentially at "growing out" of homosexuality. We believe homosexuality is an arrest in the psycho-sexual development because of failure in the bonding with members of the same sex as well as the person's own masculinity (for men) and femininity (for women).

It is also a part of the whole "homosexual personality," characterized by low self-esteem, lack of social skills, disconnection from body, and emotional isolation from society with varying degrees in different individuals. The isolation is not just because of the hatred and homophobia of society, it is an element in the psychopathology (disease process) of the disorder itself. Of course the homophobia of the society adds to it, but it is not entirely caused by it.

IOL: Do homosexuals take drugs as part of treatment or does it depend entirely on behavioral therapy?

Hanna: Treatment is essentially behavioral, cognitive, and psychodynamic (i.e. dealing with the dynamics of the family of origin and the healing of the inner child). Drugs may be used for the treatment of accompanying emotional problems like depression and/or anxiety.

IOL: Do homosexuals need to go to any other medical speciality after they finish their psychological treatment?

Hanna: Not necessarily.

IOL: According to your experience, do you find that homosexuals are shy to seek treatment?

Hanna: Yes, but this is slowly changing now.

IOL: After treatment, how can you be sure that the one you have treated will not have a setback? Is there a kind of follow-up that protects them from relapse?

Hanna: Nothing is sure. It is like the treatment of addiction. As long as the person is pursuing a healthy life, he or she will remain abstinent. With longer periods of abstinence as well as emotional growth, the attraction decreases gradually, and the opposite sex attraction starts to develop. After 15-20 years of abstinence and living a heterosexual lifestyle, the same-sex attraction almost diminishes.

However, with every "fall," the attraction is revived again and so forth. Of course following up is the rule. As in the treatment of addiction, you have to stay healthy all the time or you'll go back to the old lifestyle.

IOL: Is it a tough experience for you as a therapist to treat homosexuals?

Hanna: It is a great learning and personality development experience. Homosexuals taught me what it means that unconditional love and acceptance overcomes prejudice, cultural isolation and heals the hurts of the past. I always say that I have become a better person because of helping same sex attracted people. It is them who have healed and are continually healing me from my homophobia.

IOL: How do you view the solution to this issue?

Hanna: Fulfilling, deep, non-sexual, non-romantic same sex relationships are both the prevention in childhood and the cure in adulthood.

IOL: What do you say to those who think homosexuality is biological and that it should be left untreated?

Hanna: As a matter of fact, biology is part of the condition, not all of it. As I said before, it is a complex phenomenon. And I want to tell those who attack the treatment that they should respect the freedom of choice of those who seek treatment and want to change.